Abstract 18201: Intracoronary Optical Coherence Tomography versus Intravascular Ultrasound in ST and Non-ST Elevation Myocardial Infarction: A Nation-Wide Analysis

Abstract

Introduction: Intravascular ultrasound (IVUS) and intracoronary optical coherence tomography (OCT) are the 2 techniques of intracoronary imaging that are currently accessible modalities to precisely measure coronary diameters and characterize morphology of lesions. We aimed to compare the impact of IVUS and OCT on outcomes and 30-day readmission rates following STEMI and NSTEMI. Methods: We queried the National Readmission database (2010-2019) to identify patients with STEMI and NSTEMI, undergoing PCI and compared outcomes and 30-day readmission rates between patients undergoing IVUS-guided PCI and OCT-guided PCI. Multivariable logistic regression was performed to evaluate the odds ratios (OR) of adverse outcomes in the 2 groups Results: Of 67,479 STEMI admissions undergoing ICI-guided PCI, 65,137 underwent IVUS and 2,342 underwent OCT. Patients undergoing OCT compared to IVUS had lower Length of stay (LOS) (OR 0.98 [0.96-0.99], P<0.05). However, there was no significant difference in in-hospital mortality, 30-day readmission rate and 90-day readmission rate. Of 103,901 NSTEMI admissions undergoing ICI-guided PCI, 100,127 underwent IVUS and 3774 underwent OCT. Patients undergoing OCT compared to IVUS had lower LOS (OR 0.95 [0.93-0.98], P<0.001) and 30-day readmission rates (OR 0.84 [0.71-0.99], P<0.05), but no significant differences were found in in-hospital mortality and 90-day readmission rates Conclusions: In acute MI patients undergoing ICI-guided PCI, OCT-guided PCI during index hospitalization is associated with similar outcomes compared to IVUS-guided PCI (except better LOS and 30-day readmission rates in NSTEMI).